Provider Demographics
NPI:1871187815
Name:JOI LIFE WELLNESS GROUP, LLC
Entity Type:Organization
Organization Name:JOI LIFE WELLNESS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MITZI
Authorized Official - Middle Name:JOI
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-383-0845
Mailing Address - Street 1:1400 VETERANS MEMORIAL HWY SE STE 134-341
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2945
Mailing Address - Country:US
Mailing Address - Phone:404-376-8116
Mailing Address - Fax:404-383-0906
Practice Address - Street 1:767 CONCORD RD SE STE B
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-2625
Practice Address - Country:US
Practice Address - Phone:404-383-0845
Practice Address - Fax:404-383-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-20
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty